The healthcare system in the United States faces various challenges. Already existing healthcare laws are being amended to combat the issue of inaccessibility to medical treatment and care services. One particular amendment is the H.R.1676 - Palliative Care and Hospice Education and Training Act which mainly focuses on promote provision of efficient services. The bill requires the Department of Health and Human Services (HHS) to invest in education centers providing palliative care and hospice courses. The idea is to have these centers improve the training of health professionals in as well as establish traineeships for individuals seeking advanced certificates such as nursing and physician degrees in palliative care. HHS will be required to provide support to schools of medicine, health institutions, schools of osteopathic medicine as well as graduate medical programs that train physicians aspiring to teach palliative medicine. Understandably, the amendment focuses on promoting competence-based training exercises through awarding grants to schools of nursing, healthcare facilities and/or educational programs centered on palliative care.
One of the notable potential effects of the amendment is that it will promote growth of a body of professionals with extensive knowledge in palliative care. Currently, health institutions face challenges pertaining professionalism when it comes to providing care for the elderly (“Reed’s palliative care”, 2018). A director of innovation and advocacy at a community-based non-profit, CareFirst in Painted Post, New York, Robin Stawasz, stated that the hospice industry faces workforce issues on a daily basis. Additionally, there is a general lack of knowledge regarding palliative care services which limits organizations providing palliative care and hospice services from performing effectively (“Reed’s palliative care”, 2018). Shauna Anderson, the president and chief executive of Chautauqua Hospice and Palliative Care, stated that passage of the bill will lead to higher patient satisfaction, better care, lower costs, as well as higher provider efficiency and satisfaction (Boucher, 2016).
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The Oncology Nursing Society extends its support for the bipartisan legislation which enjoys support from both Republicans and Democrats. According to Stone (2017), palliative and end-of-life care is fundamental to oncology as it indicates the importance of minimizing psychological, social, physical, and spiritual pain and suffering among patients. In this respect, oncology nurses understand the importance of better treatment and quality of life options especially pertaining to patients suffering from cancer (Stone, 2017. For that reason, there is a need for a proactive and integrated approach towards palliative care. The bill in question promotes an interorganizational approach which encourages participation of multiple healthcare providers with the goal of improving the quality of life among patients across the continuum of care (Stone, 2017). Malloy et al. (2018) focused on the provision of palliative care education among Asian nurses. The authors noted that nurses are not only committed towards improving care for patients with serious health conditions, but also are committed to education, practice, advocacy, leadership and research which are factors that can help promote better palliative care. It becomes clear that there is a consensus as pertains to the potential impact of having a growing body of professionals equipped with knowledge in palliative care and hospice services.
However, while there are considerable benefits which will be realized following passage of the bill, a few issues arise especially pertaining to health care access via Medicare. The Affordable Care Act was created to promote better access to medical services across America. Fortunately, this particular goal was achieved. For instance, in the state of New York, the rate of uninsured dropped from 9.5% to 5.5% after the ACA took effect (“Impact of ACA Repeal”, 2017). While the proposed bill emphasizes the need for investing in educational resources to aid healthcare professionals, there is no focus on the various challenges that patients face when it comes to gaining access to care services. Arguably, the number of Americans with serious illness is growing which has intensified the need for specialized medical care (Malloy et al., 2018). That being the case, there should be focus towards already existing barriers that prevent access to medical services across various populations in the country.
Palliative care involves provision of medical care services to an individual at any point during his or her illness. However, as mentioned earlier, there is an issue regarding to access to medical coverage especially for the middle-class households. McCaughey (2017) noted that insurance companies are charging high premiums as they seek to recover from the discounts given on copays and deductions to low-income families. That being the case, it has become increasingly difficult for individuals within the middle-income threshold to access healthcare insurance. While the bill in question advocates for the benefit of investing in educational programs focused on palliative care and hospice services, it fails to address the challenges faced under the ACA. There is no mention or regard of how the middle-class, for instance, can access palliative care services without having to succumb to the pressure of high insurance premiums charged by companies. Arguably, investing in palliative care training and hospice care services cannot promote positive outcomes if those who are required to receive such high quality of care find it difficult to access it. The effect of the ACA has been far-reaching and the middle-class have opted to pay penalties which they consider being a cheaper alternative compared to acquiring insurance via the private sector (Glied & Jackson, 2017). ‘
However, despite the bill’s limitation when it comes to addressing access to health care services, it stands to have considerable benefits across the care continuum. Boucher (2016) noted that the health care industry has been experiencing a shortfall in physicians and nurses trained in palliative care services. For instance, in 2010, a task forced under the American Academy of Hospice and Palliative Medicine noted that there was a demand for 6000 to 18,000 physicians to adequately staff hospice and palliative care needs (Boucher, 2016). Therefore, the proposed bill will incentivize individuals seeking to advance their knowledge in palliative care and hospice services to enroll to educational institutions receiving federal grants. Thus, there will be increased access to palliative training, which will lead to a growing body of professionals with specialized training in this line of work. Notable outcomes will be such as provider efficiency, patient satisfaction, adherence to treatment and other care options, alongside other benefits. Furthermore, healthcare professionals will have more opportunities, for instance, to discuss end-of-life decision-making with patients. This will allow recognition of the need to expand a patient’s understanding of what options he or she has (Malloy et al., 2018). Therefore, the bill’s emphasis on professionalism will not only promote competence among nurses and physicians, but will lead to better performance across the continuum of care in the country.
Conclusion
The limitations of the ACA are likely to undermine effectiveness of the proposed bill once it is passed into law. Addressing these barriers could help promote realization of the intended effect of the bill. With a competent body of health care professionals, the health care industry will experience better efficiency in terms of provision of medical services, higher satisfaction rate among patients, job satisfaction, motivation and engagement among health care workers, inter alia. Therefore, the benefits of the bill outweigh its limitations although there is an opportunity for modifications.
References
Boucher, N. (2016). The benefits of expanded physician assistant practice in hospice and palliative medicine. American Academy of Physician Assistants, 29 (9), 38-43.
Glied, S., & Jackson, A. (2017). The future of the Affordable Care Act and insurance coverage. American Journal of Public Health , 107 (4), 538–540. http://doi.org/10.2105/AJPH.2017.303665
Impact of ACA Repeal on the 19th Congressional District of New York. (2017). Retrieved from http://hcfany.org/wp/wp-content/uploads/2017/03/NY-19th-John-Faso.pdf
Malloy, P., Takenouchi, S., Kim, H. S., Lu, Y., & Ferrell, B. (2018). Providing Palliative Care Education: Showcasing Efforts of Asian Nurses. Asia-Pacific Journal of Oncology Nursing , 5 (1), 15–20. http://doi.org/10.4103/apjon.apjon_55_17
McCaughey, B. (2017, September 6). Obamacare is making the middle class the new uninsured. New York Post . Retrieved from https://nypost.com/2017/09/06/obamacare-is-making-the-middle-class-the-new-uninsured/
Reed's palliative care, hospice training bill approved by House health subcommittee. (2018, July 10). Retrieved from https://riponadvance.com/stories/reeds-palliative-care-hospice-training-bill-approved-house-health-subcommittee/
Stone, A. (2017). ONS policy agenda and asks. Retrieved from https://www.ons.org/sites/default/files/2017%20Hill%20Days/ONS%20Policy%20Agenda%20and%20Asks.pdf
